(痫)
〔大〕妊娠体虚,受风而伤太阳之经络,后复遇风寒相搏,发则口噤背强,名之曰痉。
又云∶ ,其候冒闷不识人,须臾自醒,良久复作,谓之风痉。一名子痫,亦名子冒,甚
则反张。
〔薛〕前证若心肝风热,用钓藤汤。(胎动)肝脾血虚,加味逍遥散。(调经)肝脾郁怒,加
味归脾汤。(杂病健忘。)气逆痰滞,紫苏饮。肝火风热,钓藤散。(眩晕。)脾郁痰滞,二陈、姜
汁、竹沥。若兼证相杂,当参照子烦门。
羚羊角散 治妊娠冒闷,角弓反张,名曰子痫风痉。
羚羊角(镑) 独活 酸枣仁(炒) 五加皮 薏苡仁(炒) 防风 当归(酒浸)
川芎 茯苓(去木) 杏仁(去皮尖,各五分) 木香 甘草(炙,各二分)
上姜水煎服。
《短剧》疗妊娠忽闷,眼不识人,须臾醒复发,亦有不醒者,名为 病,亦名子痫,亦
名子冒,宜葛根汤。若竹近可速办者,当先作沥汁,次办汤也。其竹远不可即办者,当
先办汤。此二疗会得其一种,竹沥偏疗诸痉绝起死也。非但偏疗妊娠产妇绝死者有效,小
儿或痫 ,金疮发 ,疗之亦验。
葛根汤方 治妊娠临月,因发风痉,闷愦不识人,吐逆眩倒,小醒复发,名曰子
痫。
葛根 贝母(去心) 牡丹皮 木防己 防风 当归 川芎 白茯苓 桂心(熬)
泽泻 甘草(各二两) 独活 石膏(碎) 人参(各三两)
上细切,以水九升,煮取三升,分三服。贝母令人易产,若未临月者,以升麻代之。忌
海藻、菘菜、酢物。
按∶此方犯桂与牡丹,不如羚羊角散之妥。
羌活酒 治妊娠中风痉,口噤,四肢强直,角弓反张。
羌活(去芦,一两半) 防风(去芦,一两) 黑豆(一合,炒,去皮)
上二味为 咀,好酒五升,浸一宿,每服用黑豆一合,炒令熟,投入药酒一大盏,候
沸即住,去滓,分两服灌之。
〔丹〕治一妇人怀妊六月,发痫,手足
扬直,面紫黑色,合眼涎出,昏愦不醒人事,半时而醒。医与震灵丹五十余帖,其疾时作
时止,无减证,直至临产方自愈。产一女,蓐中子母皆安。次年其夫疑丹毒必作,求治之。
诊其脉,浮取弦,重取涩,按至骨则沉实带数。时正二月因未见其痫发正状,未敢与药,
意其旧年痫发时乃五月,欲待其时,度此疾必作,当审谛施治。至五月半,其疾果作,皆
是午巳两时,遂教以自制防风通圣散,用生甘草加桃仁多,红花少,或服或吐,至四五
剂,疾渐疏而轻,后发为疥而愈。
(痫证)
〔大论〕孕妇体质虚弱,感受风邪而损伤太阳经络,之后又遭遇风寒相互搏结,发作时出现牙关紧闭、背部强直的症状,这种病称为“痉”。
又说:其症状表现为头目昏蒙、胸闷且不能识人,片刻后自行苏醒,过了一段时间再次发作,这称为“风痉”。又名“子痫”,也称“子冒”,病情严重时会出现身体向后反折如弓状(角弓反张)。
〔薛己〕上述病症如果是心肝风热所致,使用钩藤汤。(针对胎动不安)如果是肝脾血虚,使用加味逍遥散。(针对月经不调)如果是肝脾郁怒,使用加味归脾汤。(针对杂病健忘)如果是气逆痰滞,使用紫苏饮。如果是肝火风热,使用钩藤散。(针对眩晕)如果是脾郁痰滞,使用二陈汤,并加入姜汁和竹沥。如果兼夹症状复杂,应当参照“子烦”门中的方法处理。
羚羊角散:治疗妊娠期间头目昏闷、角弓反张,名为子痫风痉。
组成:羚羊角(镑片)、独活、酸枣仁(炒)、五加皮、薏苡仁(炒)、防风、当归(酒浸)、川芎、茯苓(去木心)、杏仁(去皮尖,各五分)、木香、甘草(炙,各二分)。
用法:以上药物用生姜水煎服。
《短剧》记载:治疗孕妇突然昏闷,眼睛不能识人,片刻后醒来又复发,也有不醒的,这种病名为“痓”病,也名子痫,也名子冒,适宜使用葛根汤。如果附近能快速获取竹子,应当先制作竹沥汁,然后再准备汤药;如果竹子距离远无法立即获取,应当先准备汤药。这两种疗法只要能掌握其中一种即可,竹沥偏重于治疗各种痉挛导致的假死状态。不仅对妊娠产妇假死有效,小儿惊痫、金疮感染发痉等,治疗也都有效。
葛根汤方:治疗妊娠临产月,因感受风邪引发痉挛,昏闷不识人,呕吐逆乱、头晕跌倒,稍醒后又复发,名为子痫。
组成:葛根、贝母(去心)、牡丹皮、木防己、防风、当归、川芎、白茯苓、桂心(熬制)、泽泻、甘草(各二两)、独活、石膏(捣碎)、人参(各三两)。
用法:以上药物细切,用水九升,煮取三升,分三次服用。贝母有助于顺利生产,若未到临产月,可用升麻代替。忌食海藻、菘菜(白菜类)、醋物。
按语:此方含有桂枝与牡丹皮,不如羚羊角散稳妥。
羌活酒:治疗妊娠中风引发的痉挛,牙关紧闭,四肢强直,角弓反张。
组成:羌活(去芦头,一两半)、防风(去芦头,一两)、黑豆(一合,炒,去皮)。
用法:将前两味药捣成粗末,用好酒五升,浸泡一夜。每次服用时,取黑豆一合,炒熟,投入一大盏药酒,煮沸后立即停火,滤去药渣,分两次灌服。
〔丹溪〕治疗一位怀孕六个月的妇人,发生痫证,手足抽搐伸直,面色紫黑,闭眼流涎,昏闷不醒人事,半个时辰后苏醒。医生给予震灵丹五十多帖,病情时好时坏,没有减轻,直到临产才自愈。生下一个女儿,产后母子平安。次年,其丈夫怀疑是丹毒必然发作,求治于我。诊察其脉象,轻取弦脉,重取涩脉,按至骨则沉实带数。当时正值二三月,因为未见其痫证发作的正状,不敢给药,推测她旧年发病是在五月,打算等到那时,估计此病必定会发作,届时再仔细审察施治。到了五月半,病情果然发作,都是在午时和巳时两个时辰,于是教给她自制防风通圣散,重用生甘草和桃仁,少用红花,或内服或催吐,服用四五剂后,病情逐渐疏解变轻,后来身上发出疥疮而痊愈。
(Seizure Disorder)
[Da Lun] When a pregnant woman has a weak constitution and is affected by wind pathogen, damaging the meridians of the Taiyang (Greater Yang), followed by a subsequent struggle between wind and cold pathogens, the onset presents with locked jaws and stiffness of the back. This condition is named "Jing" (Spasm).
It is also stated: The symptoms include dizziness, chest oppression, and loss of consciousness. After a short while, she awakens spontaneously, but the condition recurs after a long interval. This is called "Feng Jing" (Wind Spasm). It is also known as "Zi Xian" (Eclampsia of Pregnancy) or "Zi Mao" (Dizziness of Pregnancy). In severe cases, it manifests as opisthotonos (backward arching of the body like a bow).
[Xue Ji] If the aforementioned symptoms are due to Wind-Heat in the Heart and Liver, use Gouteng Tang (Uncaria Decoction). [For restless fetus] If due to Blood Deficiency of the Liver and Spleen, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). [For irregular menstruation] If due to Stagnation and Anger of the Liver and Spleen, use Jiawei Guipi Tang (Modified Restore the Spleen Powder). [For forgetfulness in miscellaneous diseases] If due to Qi Reversal and Phlegm Stagnation, use Zisu Yin (Perilla Infusion). If due to Liver Fire and Wind-Heat, use Gouteng San (Uncaria Powder). [For vertigo] If due to Spleen Stagnation and Phlegm Stagnation, use Erchen Tang (Two-Aged Phlegm Decoction) with Ginger Juice and Bamboo Sap. If complicated symptoms are mixed, refer to the section on "Zi Fan" (Restlessness of Pregnancy).
Lingyangjiao San (Antelope Horn Decoction): Treats pregnancy accompanied by dizziness and chest oppression, opisthotonos, named Zi Xian Feng Jing (Eclamptic Wind Spasm).
Ingredients: Lingyang Jiao (Antelope Horn, sliced), Duhuo (Angelicae Pubescentis Radix), Suanzao Ren (Ziziphi Spinosae Semen, stir-fried), Wujia Pi (Acanthopanacis Cortex), Yiyiren (Coicis Semen, stir-fried), Fangfeng (Saposhnikoviae Radix), Danggui (Angelicae Sinensis Radix, soaked in wine), Chuanxiong (Ligustici Chuanxiong Rhizoma), Fuling (Poria, woody core removed), Xingren (Armeniacae Semen Amarum, skin and tip removed, each 5 fen), Muxiang (Aucklandiae Radix), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 2 fen).
Usage: Decoct the above ingredients with water containing fresh ginger and take orally.
"Duan Ju" records: To treat sudden faintness in pregnancy, inability to recognize people with eyes open, awakening after a moment only to relapse, or even failing to awaken. This disease is named "Chi Bing" (Spasm Disease), also Zi Xian (Eclampsia), or Zi Mao (Dizziness of Pregnancy). Ge Gen Tang (Puerariae Radix Decoction) is appropriate. If bamboo is nearby and can be obtained quickly, prepare Zhu Li (Bamboo Sap) first, then the decoction. If bamboo is far away and cannot be obtained immediately, prepare the decoction first. Mastering either method is sufficient; Zhu Li (Bamboo Sap) is particularly effective for treating various spasms leading to apparent death. It is not only effective for pregnant women appearing dead from eclampsia, but also verified for pediatric convulsions, traumatic wounds with tetanus-like spasms, etc.
Ge Gen Tang Formula: Treats pregnancy near term, where wind pathogen induces spasm, causing faintness, loss of recognition, vomiting, dizziness, and falling, with brief awakenings followed by recurrence, named Zi Xian (Eclampsia).
Ingredients: Gegen (Puerariae Radix), Beimu (Fritillariae Bulbus, heart removed), Mudanpi (Moutan Cortex), Mugongji (Stephaniae Tetrandrae Radix), Fangfeng (Saposhnikoviae Radix), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Bai Fuling (Poria), Guixin (Cinnamomi Ramulus, processed), Zexie (Alismatis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, each 2 liang), Duhuo (Angelicae Pubescentis Radix), Shigao (Gypsum Fibrosum, crushed), Renshen (Ginseng Radix, each 3 liang).
Usage: Finely cut the ingredients. Boil in 9 sheng of water until reduced to 3 sheng. Divide into three doses. Beimu (Fritillariae Bulbus) facilitates easy delivery; if not yet near term, substitute with Shengma (Cimicifugae Rhizoma). Avoid eating Haizao (Sargassum), Songcai (Brassica vegetables), and vinegar products.
Note: This formula contains Guizhi (Cinnamon Twig) and Mudanpi (Moutan Cortex), which is less suitable than Lingyangjiao San.
Qianghuo Jiu (Notopterygii Wine): Treats wind-stroke-induced spasm in pregnancy, characterized by locked jaws, stiffness of the four limbs, and opisthotonos.
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix, rhizome removed, 1.5 liang), Fangfeng (Saposhnikoviae Radix, rhizome removed, 1 liang), Heidou (Sojae Semen Nigrum, 1 he, stir-fried, skin removed).
Usage: Coarsely crush the first two herbs. Soak in 5 sheng of good wine overnight. For each dose, take 1 he of stir-fried black beans, cook them thoroughly, add one large cup of the medicinal wine, boil until bubbling, then remove from heat. Strain the dregs. Divide into two doses and administer forcibly.
[Danxi] Treated a woman who was six months pregnant and suffered from seizures. Her hands and feet extended stiffly, her face turned purple-black, her eyes were closed with saliva flowing out, and she was unconscious and unresponsive. She woke up after half an hour. Physicians administered Zhenling Dan (Vibrating Spirit Pill) for over fifty doses. The disease came and went intermittently without reduction in severity, only resolving spontaneously upon delivery. She gave birth to a daughter, and both mother and child were safe postpartum. The following year, her husband suspected the pills caused toxicity and sought treatment. Her pulse was wiry on light pressure, choppy on heavy pressure, and deep, solid, and rapid when pressed to the bone. At that time, it was February or March. Since the typical seizure pattern had not been observed, I dared not prescribe medicine. I reasoned that her previous seizures occurred in May, so I waited until then, anticipating the disease would recur, to observe carefully and treat accurately. By mid-May, the disease indeed recurred, specifically during the Wu (11 AM - 1 PM) and Si (9 AM - 11 AM) hours. I instructed her to use my self-made Fangfeng Tongsheng San (Saposhnikovia Unblocking the Intestines Powder), using a larger amount of raw Gancao (Licorice Root) and Tao Ren (Persicae Semen), and a smaller amount of Honghua (Carthami Flos). Administered orally or inducing vomiting, after four or five doses, the disease gradually subsided and became milder. Eventually, she developed scabies (skin eruptions) and recovered.